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Intra‐epidermal bodies (IEBs) are large dynamic circular structures that form within fish scale epidermis. IEBs are believed to reflect the sequestering of intra‐epidermal debris, such as damaged or dead cells, within the epidermis. The present report describes an association between a giant cell that patrols the epidermis and the formation of IEBs. The giant cell, likely macrophage‐related, is a broadly spread cell with lengths up to ~90 μm and average spread areas >600 μm2. Time‐lapse video microscopy was used to monitor formation of IEBs and determine any association between the IEB and the giant cells. Giant cells were observed to form IEBs, and as an IEB dissipated a giant cell was observed to exit the area previously occupied by the IEB. These observations suggest the IEB is a transitional form of the giant cell, serving as a temporary compartment to isolate and initiate breakdown of the debris scavenged by the giant cell. [ABSTRACT FROM AUTHOR]

Background: Dysgerminomas constitute around 1–2% of all germ cell tumours. It is very very rare to have dysgerminoma with concurrent pregnancy with an incidence of 0.2–1 per 100,000 pregnancies. It is extremely difficult to conceive with no assisted reproductive interventions and carry it till completion with no complications in a concurrent dysgerminoma. Dysgerminoma has a characteristic specific histomorphology and is easy to diagnose. However, occasionally, syncytiotrophoblastic differentiation can be seen in dysgerminoma although it is a rare histopathological finding. Also, the raised serum B-HCG levels due to the syncytiotrophoblast giant cells seen can lead to a diagnostic dilemma. Clinical presentation: Here we report a case of a 27-year-old 8-week pregnant female who came to the hospital with chief complaints of left-sided abdominal pain and a lump abdomen. Clinical and radiological examination revealed a left ovarian tumour of malignant aetiology with the presence of right ectopic pregnancy. A staging laparotomy with left salpingoophorectomy was performed and sent for histopathological examination. It was reported as dysgerminoma with syncytiotrophoblastic giant cells. The right fallopian tube showed products of conception. Finally, she was planned for adjuvant chemotherapy and serial B-HCG levels. Summary: This case is reported not only just for its rare histopathological finding but also for the diagnostic dilemma it causes both to the surgeon as well as the pathologist. There are various factors which can act as prognosticators such as early suspicion of a tumor, radiological findings, surgery, histopathological examination, and oncology team. [ABSTRACT FROM AUTHOR]

COVID-19 can induce cardiac involvement, which can include myocardial infarction, various types of arrhythmia, atrioventricular block, myocarditis, acute heart failure, and sudden cardiac death, in approximately 30% of infected patients. There are some reports on the triggering of sarcoid-like reactions and inflammatory myocardial processes by various types of infections. However, little is known about the relationship between COVID-19 and inflammatory cardiomyopathies such as cardiac sarcoidosis (CS) and giant cell myocarditis (GCM). Herein, we describe the clinical course, management, and follow-up of an unmasked inflammatory cardiomyopathy in a 57-year-old Iranian woman, who presented with ventricular arrhythmia 4 months after mild COVID-19 infection. The onset of symptomatic inflammatory myocardial disorders such as CS or GCM may be triggered by COVID-19 infection. The best approach to the management of myocardial inflammatory COVID-19 should probably be individualized based on the patient’s clinical presentation and severity of cardiac involvement.

Plant parasitic root-knot nematodes are major agricultural pests worldwide, as they infect plant roots and cause substantial damages to crop plants. Root-knot nematodes induce specialized feeding cells known as giant cells (GCs) in the root vasculature, which serve as nutrient reservoirs for the infecting nematodes. Here, we show that the cell walls of GCs thicken to form pitted patterns that superficially resemble metaxylem cells. Interestingly, VASCULAR-RELATED NAC-DOMAIN1 (VND1) was found to be upregulated, while the xylem-type programmed cell death marker XYLEM CYSTEINE PEPTIDASE 1 was downregulated upon nematode infection. The vnd2 and vnd3 mutants showed reduced secondary cell wall pore size, while the vnd1 vnd2 vnd3 triple mutant produced significantly fewer nematode egg masses when compared with the wild type. These results suggest that the GC development pathway likely shares common signaling modules with the metaxylem differentiation pathway and VND1, VND2 , and VND3 redundantly regulate plant–nematode interaction through secondary cell wall formation. [ABSTRACT FROM AUTHOR]

Giant cell tumor (GCT) is a benign, locally aggressive neoplasm with a high recurrence rate with common occurrence in the long bone and the cases in the maxillofacial region bone are very rare. Due to the paucity of the cases, there is not enough information available regarding the behavior of the tumor. Also, the differentiation of this aggressive lesion with the commonly occurring reactive giant cell lesions is crucial and needs more research. This study is pertaining to the review of literature of the cases of GCT in the oral cavity with their clinicopathological, radiographic, and biochemical analyses. Although there are no available studies regarding the immunohistochemical characteristics of this lesion, this study is the first step in this direction to differentiate this tumor better and identify the possible pathogenesis. [ABSTRACT FROM AUTHOR]

A 45‐year‐old woman with neurofibromatosis type 1 (NF1) developed a tumor in the left frontal lobe that showed features of giant cell glioblastoma (GC‐GB). In addition to the typical GC‐GB features, the tumor showed lipogenic differentiation, with many atypical lipoblasts and mature adipocytes. Tumor cells, including the lipogenic cells, were immunoreactive for GFAP, S‐100 protein, ATRX, and p53. They were negative for IDH1‐R132H, BRAF V600E, synaptophysin, NeuN, p16, mismatch repair proteins, and CD34. The patient is free from recurrence at approximately two years postoperatively. This is the fifth reported case of NF1‐associated GC‐GB (the second adult case). NF1 gene mutation might have played a role in the pathogenesis of lipogenic differentiation of GC‐GB. The differential diagnosis of lipidized GC‐GB from gliosarcoma or anaplastic pleomorphic xanthoastrocytoma is briefly discussed. [ABSTRACT FROM AUTHOR]

Left-to-right differences in the histopathologic patterns of transthyretin-derived amyloid (ATTR) deposition in the atria of older adults have not yet been investigated. Hence, this study evaluated heart specimens from 325 serial autopsy subjects. The amount of ATTR deposits in the seven cardiac regions, including both sides of atria and atrial appendages, was evaluated semiquantitatively. Using digital pathology, we quantitatively evaluated the immunohistochemical deposition burden of ATTR in the myocardium. We identified 20 sporadic ATTR cardiac amyloidosis cases (nine males). All patients had ATTR deposition in the left atrial regions of the myocardium. In the semiquantitative analysis, 14 of the 20 cases showed more severe ATTR deposition on the left atrial regions than on the right side, with statistically significant differences in the pathology grading (p < 0.01 for both the atrium and atrial appendage). Quantitative analysis further supported the difference. Moreover, six had ATTR deposition in the epineurium and/or neural fibers of the atria. Cluster analysis revealed that ATTR deposition in the myocardium was significantly more severe in males than in females. The heterogeneous distribution of amyloid deposits between atria revealed in this study may impair the orderly transmission of the cardiac conduction system and induce arrhythmias, which may be further aggravated by additional neuropathy in the advanced phase. This impairment could be more severe among males. These findings emphasize that atrial evaluation is important for individuals with sporadic ATTR cardiac amyloidosis, particularly for early detection. [ABSTRACT FROM AUTHOR]

Purpose: To determine and report the underlying cause of local inflammation causing recurrent neuropathy and multiple operations in a patient with a Barricaid® device. Methods: After removal of this patient's Barricaid® device, we sent local inflammatory tissue to pathology for histochemical analysis. Upon discovery of giant cells formation with polarizable foreign bodies, we performed a literature review regarding the Barricaid® device and its elements. Results: After two previous operations and three trials of conservative management, the presented patient underwent an L5/S1 TLIF with removal of her previously installed Barricaid® device. There were no signs of device instability/failure nor were there obvious signs of infection. Inflamed tissue proximal to the Barricaid® device was discovered, debrided, and sample sent to pathology. Removal of the Barricaid® device led to subsequent and durable relief of her symptoms. During review of this case, we discovered the polyethylene terephthalate (PET) weave used in the Barricaid® device is known to induce foreign body reactions, and this precise finding was seen in the majority of animal data submitted to the FDA for the device's acceptance. Conclusion: Given the constellation of this patient's symptoms, imaging, intraoperative, and pathology findings, previously published reports, and pre-approval data submitted to the FDA, we conclude that the inflammatory response to the PET weave in this patient's Barricaid® device was the ultimate cause of her continued neuropathy despite multiple prior surgical interventions. [ABSTRACT FROM AUTHOR]

Giant cell carcinomas of the lung (GCCL) are aggressive tumors, with most patients having metastatic disease at presentation. However, giant cell carcinomas of the lungs are rare and account for 0.1%–0.4% of primary lung malignancies. Thus, the literature on the disease is limited. This case report presents an asymptomatic young patient with an incidental lung mass on a background of childhood abdominal rhabdomyosarcoma with lung metastasis. After undergoing surgical resection , the final tumor pathology was in keeping with primary giant cell carcinoma. The purpose of this case report is to contribute to the understanding of giant cell carcinomas of the lung. [ABSTRACT FROM AUTHOR]

Coevolution of hosts and their parasites has shaped heterogeneity of effector hemocyte types, providing immune defense reactions with variable effectiveness. In this work, we characterize hemocytes of Drosophila willistoni, a species that has evolved a cellular immune system with extensive variation and a high degree of plasticity. Monoclonal antibodies were raised and used in indirect immunofluorescence experiments to characterize hemocyte subpopulations, follow their functional features and differentiation. Pagocytosis and parasitization assays were used to determine the functional characteristics of hemocyte types. Samples were visualized using confocal and epifluorescence microscopy. We identified a new multinucleated giant hemocyte (MGH) type, which differentiates in the course of the cellular immune response to parasitoids. These cells differentiate in the circulation through nuclear division and cell fusion, and can also be derived from the central hematopoietic organ, the lymph gland. They have a binary function as they take up bacteria by phagocytosis and are involved in the encapsulation and elimination of the parasitoid. Here, we show that, in response to large foreign particles, such as parasitoids, MGHs differentiate, have a binary function and contribute to a highly effective cellular immune response, similar to the foreign body giant cells of vertebrates. [ABSTRACT FROM AUTHOR]

Mönckeberg’s calcification is a disease of low prevalence and unknown etiology that causes calcification of the middle layer of medium and small arteries. It usually presents with a clinical picture similar to giant cell arteritis, so a differential diagnosis with similar entities should be made. The diagnosis is anatomopathological, and there is no treatment that has shown significant results. Herein, we present the case of a 74-year-old male patient with recurrent syncope and chest pain, in whom giant cell arteritis was suspected and a temporal artery biopsy was taken with the incidental finding of calcification of Mönckeberg’s media. [ABSTRACT FROM AUTHOR]

Vasculitis, a group of systemic inflammatory diseases that affect the cardiovascular (CV) system, presents with a variety of clinical manifestations that depend on the size of the affected blood vessels. While some types of vasculitis reveal distinct symptoms, others are characterized by more diffuse and nonspecific presentations that can result in delayed diagnosis and treatment initiation. Interestingly, patients with vasculitides share a significant comorbidity: an elevated CV risk, contributing to increased rates of CV events and mortality. This heightened risk is caused by cumulative inflammatory burden, traditional CV risk factors, medication effects, and reduced physical fitness. Traditional risk assessment tools, commonly used in the general population, frequently underestimate the CV risk in patients with inflammatory rheumatic conditions. Consequently, novel approaches are necessary to stratify the precise CV risk in vasculitis patients. A number of surrogate parameters for CV risk have been investigated, with arterial stiffness emerging as a promising marker. Pulse wave velocity (PWV) is a well-established method for assessing arterial stiffness and predicting CV risk across different populations. Among numerous PWV variants, carotid–femoral PWV (cfPWV) stands out as the most extensively studied and accepted reference standard. It has demonstrated its utility as a surrogate CV parameter both in the general population and in patients with systemic inflammatory rheumatic diseases. In recent years, research has expanded to assess arterial stiffness in systemic rheumatic diseases, such as arthritis, connective tissue diseases, rheumatologic overlap syndromes, and chronic pain disorders, using measurements of PWV and other markers of arterial compliance and elasticity. Despite burgeoning research in rheumatologic diseases, data on CV risk markers in vasculitides remain limited and fragmented. This narrative review aims to provide a comprehensive overview of arterial stiffness as a potential screening marker for CV diseases, atheromatosis, and ultimately CV risk among patients with vasculitides. [ABSTRACT FROM AUTHOR]

Giant cell-rich osteosarcoma (GCRO) is a rare variant of osteosarcoma. A significant diagnostic hurdle is presented by the lesion’s uncommon appearance on histopathology. This report presents a case of a 59-year-old female patient diagnosed with GCRO. Contribution: While it is extremely difficult to distinguish GCRO from malignant giant cell tumour, it is important to do so because of the difference in prognosis and management. Distinctive anatomy of the lumbar spine increases the risks associated with surgical excision.

Annular elastolytic giant cell granuloma (AEGCG) is a rare granulomatous skin condition. It belongs to a group of skin and elastic fiber disorders. When it affects sun-exposed skin, it is also called actinic granuloma. The etiology and pathogenesis are still debated. However, sun-induced actinic damage to elastic fibers is acknowledged as the primary triggering factor, though the pathogenesis of instances in sun-covered areas is unknown. The most commonly linked systemic illness is diabetes mellitus. Different case reports show an association of this disease with hematological conditions, infections, sarcoidosis, and protoporphyria. Multisystemic involvement was also reported in a case. The disease is clinically recognized by erythematous non-scaly annular patches and plaques with raised borders and hypopigmented or skin-colored centers, sometimes atrophic. It is usually asymptomatic or mildly itchy. The presence of an inflammatory infiltration with non-palisading granulomas, multinucleate large cells, elastin degradation, and elastophagocytosis, as well as the absence of necrobiosis and mucin, are histopathological characteristics. We report a 5-year history of annular elastolytic giant cell granuloma in a 66-year-old woman with a history of type two diabetes mellitus, hypertension, and fatty liver disease (steatosis). She presented with asymptomatic polymorphic erythematous skin lesions mainly in sun-exposed areas.

Left-to-right differences in the histopathologic patterns of transthyretin-derived amyloid (ATTR) deposition in the atria of older adults have not yet been investigated. Hence, this study evaluated heart specimens from 325 serial autopsy subjects. The amount of ATTR deposits in the seven cardiac regions, including both sides of atria and atrial appendages, was evaluated semiquantitatively. Using digital pathology, we quantitatively evaluated the immunohistochemical deposition burden of ATTR in the myocardium. We identified 20 sporadic ATTR cardiac amyloidosis cases (nine males). All patients had ATTR deposition in the left atrial regions of the myocardium. In the semiquantitative analysis, 14 of the 20 cases showed more severe ATTR deposition on the left atrial regions than on the right side, with statistically significant differences in the pathology grading (p < 0.01 for both the atrium and atrial appendage). Quantitative analysis further supported the difference. Moreover, six had ATTR deposition in the epineurium and/or neural fibers of the atria. Cluster analysis revealed that ATTR deposition in the myocardium was significantly more severe in males than in females. The heterogeneous distribution of amyloid deposits between atria revealed in this study may impair the orderly transmission of the cardiac conduction system and induce arrhythmias, which may be further aggravated by additional neuropathy in the advanced phase. This impairment could be more severe among males. These findings emphasize that atrial evaluation is important for individuals with sporadic ATTR cardiac amyloidosis, particularly for early detection.

Evaluation of bone pathology within the head and neck region, particularly the gnathic bonesis is complex, demonstrating unique pathologic processes. In part, this variation is due to odontogenesis and the embryological cells that may be involved, which can contribute to disease development and histologic variability. As with any boney pathosis, the key is to have clinical correlation, particularly with radiographic imaging prior to establishing a definitive diagnosis. This review will cover those entities that have a predilection for the pediatric population, and while it is not all inclusive, it should serve as a foundation for the pathologist who is evaluating bony lesions involving the craniofacial skeleton. [ABSTRACT FROM AUTHOR]

Intra‐epidermal bodies (IEBs) are large dynamic circular structures that form within fish scale epidermis. IEBs are believed to reflect the sequestering of intra‐epidermal debris, such as damaged or dead cells, within the epidermis. The present report describes an association between a giant cell that patrols the epidermis and the formation of IEBs. The giant cell, likely macrophage‐related, is a broadly spread cell with lengths up to ~90 μm and average spread areas >600 μm2. Time‐lapse video microscopy was used to monitor formation of IEBs and determine any association between the IEB and the giant cells. Giant cells were observed to form IEBs, and as an IEB dissipated a giant cell was observed to exit the area previously occupied by the IEB. These observations suggest the IEB is a transitional form of the giant cell, serving as a temporary compartment to isolate and initiate breakdown of the debris scavenged by the giant cell. [ABSTRACT FROM AUTHOR]

Giant cell fibroma is a benign oral fibrous tumour. The clinical appearance of majority of non-neoplastic fibrous growths is similar, but unique histopathological features of giant cell fibroma aid in its final diagnosis. It usually manifests as an asymptomatic, sessile or pedunculated mass usually less than 1 cm in diameter. In this case report, we highlight a case of giant cell fibroma in a 58-year-old male patient, which had an unusual size with associated pain. Although giant cell fibromas are benign lesions, it is important for dentists to be aware of this lesion based on its frequency of occurrence and need for its accurate diagnosis. [ABSTRACT FROM AUTHOR]

A giant-cell fibroma (GCF) is a benign, localized mucosal mass composed of fibrous tissue that exhibits clinical similarities to other fibro-epithelial growths. Its differentiation from other lesions relies on its distinctive histopathological characteristics. GCF is a rare oral fibrous lesion, often misdiagnosed as other fibrous growths. The first case involves a 24-year-old female with a GCF located near mandibular buccal gingiva. The second case centers on a 14-year-old boy who developed GCF on the incisive papilla region. These cases shed light on the diverse clinical manifestations and histopathological markers used in the diagnosis of GCF. The report delves into the clinical presentation, histological features, and differential diagnoses, offering valuable insights for oral healthcare professionals. Understanding the occurrence of GCF on different aspects of the gingiva is crucial for accurate diagnosis and effective treatment. This report contributes to the growing body of knowledge regarding this rare oral lesion and emphasizes the importance of considering GCF in the differential diagnosis of gingival growths. [ABSTRACT FROM AUTHOR]

Gingival diseases are commonly observed in children and young adults. However, Giant Cell Fibroma (GCF) is a rare occurrence in children, accounting for only 2.2-7.3% of oral fibrous tumour cases. Clinically, these lesions often resemble squamous papillomas, and a definitive diagnosis can only be confirmed through histopathological {Haematoxylin and Eosin (H&E)} examination. Hereby, the authors present a rare case of gingival GCF in a three-year-old boy who presented with a pebbly growth on the mandibular gingiva. Initially, the lesion was clinically diagnosed as a papilloma and subsequently excised. The final diagnosis of GCF was established through histological examination. It is crucial for paediatric dentists to consider GCF as a differential diagnosis for lesions, particularly those with a papillary surface. Additionally, submitting all excised specimens for histopathological examination is recommended. [ABSTRACT FROM AUTHOR]

Infection by the root-knot nematode (RKN), Meloidogyne incognita, impacts crop productivity worldwide, including parsley cultures (Petroselinum crispum). Meloidogyne infection involves a complex relationship between the pathogen and the host plant tissues, leading to the formation of galls and feeding sites that disorganize the vascular system, affecting the development of cultures. Herein, we sought to evaluate the impact of RKN on the agronomic traits, histology, and cell wall components of parsley, with emphasis on giant cell formation. The study consisted of two treatments: (i) control, where 50 individuals of parsley grew without M. incognita inoculation; and (ii) inoculated plants, where 50 individuals were exposed to juveniles (J2) of M. incognita. Meloidogyne incognita infection affected the development of parsley, reducing the growth of some agronomical characteristics such as root weight and shoot weight and height. Giant cell formation was noticed at 18 days after inoculation, promoting disorganization of the vascular system. Epitopes of HGs detected in giant cells reveal the continuous capacity of giant cells to elongate under the stimulus of RKN, essential processes for feeding site establishment. In addition, the detection of epitopes of HGs with low and high methyl-esterified groups indicates the PMEs activity despite biotic stress. [ABSTRACT FROM AUTHOR]

Gingival diseases are commonly observed in children and young adults. However, Giant Cell Fibroma (GCF) is a rare occurrence in children, accounting for only 2.2-7.3% of oral fibrous tumour cases. Clinically, these lesions often resemble squamous papillomas, and a definitive diagnosis can only be confirmed through histopathological {Haematoxylin and Eosin (H&E)} examination. Hereby, the authors present a rare case of gingival GCF in a three-year-old boy who presented with a pebbly growth on the mandibular gingiva. Initially, the lesion was clinically diagnosed as a papilloma and subsequently excised. The final diagnosis of GCF was established through histological examination. It is crucial for paediatric dentists to consider GCF as a differential diagnosis for lesions, particularly those with a papillary surface. Additionally, submitting all excised specimens for histopathological examination is recommended.

Simple Summary: OFC (Osteitis Fibrosa Cystica) and Brown Tumours, skeletal lesions commonly found in chronic kidney disease (CKD) patients, are influenced by various risk factors, such as age, sex, medications affecting calcium metabolism, and vitamin D deficiency. The primary cause is secondary hyperparathyroidism, leading to imbalances in calcium and phosphorus levels and osteoclast activation. Other factors, like RAAS hyperactivity and chronic inflammation, may also contribute to their development. The recently described involvement of KRAS mutations turned Brown Tumours from reactive lesions to potentially neoplastic lesions. To manage these conditions, pharmacologic treatments like bisphosphonates, calcimimetics, vitamin D supplementation, and denosumab can help by reducing hyperparathyroidism, restoring calcium levels, and preventing OFC occurrence. Brown Tumours, being rare, lack sufficient understanding regarding their manifestation and treatment. However, considering their impact on CKD patients' quality of life, it is crucial for nephrologists and medical practitioners working with dialysis patients to be aware of various diagnostic and treatment options. Osteitis fibrosa cystica (OFC) and Brown Tumours are two related but distinct types of bone lesions that result from the overactivity of osteoclasts and are most often associated with chronic kidney disease (CKD). Despite their potential consequences, these conditions are poorly understood because of their rare prevalence and variability in their clinical manifestation. Canonically, OFC and Brown Tumours are caused by secondary hyperparathyroidism in CKD. Recent literature showed that multiple factors, such as hyperactivation of the renin–angiotensin–aldosterone system and chronic inflammation, may also contribute to the occurrence of these diseases through osteoclast activation. Moreover, hotspot KRAS mutations were identified in these lesions, placing them in the spectrum of RAS–MAPK-driven neoplasms, which were until recently thought to be reactive lesions. Some risk factors contributed to the occurrence of OFC and Brown Tumours, such as age, gender, comorbidities, and certain medications. The diagnosis of OFC and Brown Tumours includes clinical symptoms involving chronic bone pain and laboratory findings of hyperparathyroidism. In radiological imaging, the X-ray and Computed tomography (CT) scan could show lytic or multi-lobular cystic alterations. Histologically, both lesions are characterized by clustered osteoclasts in a fibrotic hemorrhagic background. Based on the latest understanding of the mechanism of OFC, this review elaborates on the manifestation, diagnosis, and available therapies that can be leveraged to prevent the occurrence of OFC and Brown Tumours. [ABSTRACT FROM AUTHOR]

Simple Summary: Giant cells (GCs) are found in many different tissues and among different backgrounds, including reactive, and neoplastic settings. It is not yet fully understood whether GCs in similar settings or with related functions share the same surface antigen expression. We performed antigen profiling of GCs via immunohistochemistry in multiple reactive and neoplastic lesions. We were able to characterise distinct groups of GCs with similar expression patterns, as well as GCs in some lesions that had a unique antigen expression pattern. These findings may help in the diagnosis of histologically similar GC-rich lesions and provide further insight into the function and origin of these cells. Giant cells (GCs) are thought to originate from the fusion of monocytic lineage cells and arise amid multiple backgrounds. To compare GCs of different origins, we immunohistochemically characterised the GCs of reactive and neoplastic lesions (n = 47). We studied the expression of 15 molecules including HLA class II molecules those relevant to the cell cycle, bone metabolism and lineage affiliation. HLA-DR was detectable in the GCs of sarcoidosis, sarcoid-like lesions, tuberculosis, and foreign body granuloma. Cyclin D1 was expressed by the GCs of neoplastic lesions as well as the GCs of bony callus, fibroid epulis, and brown tumours. While cyclin E was detected in the GCs of all lesions, p16 and p21 showed a heterogeneous expression pattern. RANK was expressed by the GCs of all lesions except sarcoid-like lesions and xanthogranuloma. All GCs were RANK-L-negative, and the GCs of all lesions were osteoprotegerin-positive. Osteonectin was limited to the GCs of chondroblastoma. Osteopontin and TRAP were detected in the GCs of all lesions except xanthogranuloma. RUNX2 was heterogeneously expressed in the reactive and neoplastic cohort. The GCs of all lesions except foreign body granuloma expressed CD68, and all GCs were CD163- and langerin-negative. This profiling points to a functional diversity of GCs despite their similar morphology. [ABSTRACT FROM AUTHOR]

Giant cell arteritis is an autoimmune disease that affects medium and large caliber vessels, creating deposits of inflammatory clusters on the arterial wall. It is the most common form of large vessel vasculitis, but given the variability of biopsy efficiency and of other diagnostic strategies employed, the diagnosis of this disease is challenging. We report the case of a 69-year-old female patient who presented with neurological deficit and increased bilateral sensation in the temporal region associated with excruciating headache. Workup revealed calcification of the superficial temporal, vertebral and ophthalmic arteries, as well as suggestive findings on Doppler ultrasound such as the halo sign, pointing to superficial temporal arteritis though not excluding the possibility of those calcifications being consistent with atherosclerosis in a patient with advanced chronic renal disease, which has been reported as giving rise to false-positive results. Knowledge of the main differences between the 2 diagnoses is important, given the wide range of diagnostic imaging possibilities which can avoid the need for biopsy.

Benign fibro-osseous lesions are a diverse range of entities that have distinct clinical and radiographic features. They can occur as solitary lesions or concomitant with other pathologies as hybrid lesions. Fibrous dysplasia (FD) accompanied by central giant cell granuloma (CGCG), peripheral giant cell granuloma (PGCG) or peripheral ossifying fibroma (POF) as hybrid lesions, is reported very rarely in the literature. Although we were unable to find any reports of FD with PGCG as a hybrid lesion. Fibro-osseous lesions have certain histopathological features in common with PGCG including multinucleated giant cells. Here we report a 28 year old female with a painless, slow growing and pedunculated swelling of the maxilla for 18 months. Differential diagnosis consisted of FD, cemento-ossifying fibroma (COF), chondrosarcoma and probable PGCG considering radiographic and clinical investigations. Histopathologic findings revealed PGCG and FD as a hybrid lesion. The combination of PGCG and FD has not been reported in the literature so far. [ABSTRACT FROM AUTHOR]

Objective: Unknown etiology. Background: Peripheral giant cell granuloma, or epulis, is a common and benign oral lesion that can grow rapidly. Diode lasers are increasingly used to excise soft-tissue lesions because the technique preserves tissue for histopathology while controlling bleeding. Here, we report the excision of a 2-cm benign peripheral giant cell granuloma of the oral mucosa by 975-nm infrared diode laser, with rapid wound healing and good tissue preservation for histological analysis. Case Report: A 39-year-old woman presented with a large red-purple lesion in the oral mucosa of the lower jaw, near teeth 41 and 32. According to the patient, despite the absence of pain, the lesion caused difficulty while eating, speaking, and maintaining oral hygiene. The periodontal assessment included the following parameters: clinical attachment level, gingival recession, pocket probing depth, Loe-Silness gingival index, and tooth mobility index. The lesion was excised under local anesthesia using a 975-nm diode laser, and histopathology reports confirmed the diagnosis of peripheral giant cell granuloma. Six weeks after removal of the peripheral giant cell granuloma, all periodontal parameters were improved except for clinical attachment level and gingival recession. Conclusions: Excision by 975-nm infrared diode laser can maintain tissue integrity for histopathology while allowing complete excision and control of bleeding. Soft lasers can provide advantages such as reduced bleeding, less operative and postoperative pain, decreased mechanical trauma, increased patient acceptability, and rapid wound healing without sutures, and they can be used to successfully remove peripheral giant cell granulomas. [ABSTRACT FROM AUTHOR]

Neoplasms of bone with numerous non-neoplastic osteoclast type giant cells are relatively common and exhibit diverse phenotypes of the neoplastic cells. These tumors have a broad spectrum of biological potential which necessitates accurate recognition and diagnosis. Their clinicopathological features are overlapping, therefore, immunohistochemistry and molecular studies may be required for evaluation. Correlation with imaging studies provides additional information that should be incorporated into the pathological interpretation. [ABSTRACT FROM AUTHOR]

Malignant tenosynovial giant cell tumor (TsGCT) is a rare disease that can arise as a recurrent lesion or co-exist with a benign TsGCT lesion. Here we report a rare case of malignant TsGCT in a 73-year-old male with a history of lymphoma. The tumor appeared as a superficial soft-tissue mass in the subcutaneous fat tissue of the left knee.

It is often documented that chronic irritation could be an etiology of oral cancer; yet out of negligence little heed is paid to any sort of discomfort until it grows to a sizable mass where it is difficult to go unnoticed. Intraorally, the source of irritation could vary from a jagged tooth edge to a chronic cheek bite. Furthermore, the removable prosthesis and orthodontic appliances can lead to alteration of the oral mucosal tissue. This case report represents one such sequelae of an ill-fitting dental prosthesis. Surprisingly and unfortunately, the broken denture was still in use by the patient until the damage caused by it could no further be ignored, it is then that the patient sought medical help. A histopathological diagnosis of reparative giant cell granuloma was made, and the patient was treated by successful excision of the same.

Adenocarcinoma of prostate with pleomorphic giant cells is very rarely encountered entity. It is necessary to identify this variant due to its highly aggressive clinical course and bad prognosis. Though this variant has been described in other sites, very few cases has been reported in the prostate till date. We report one such case with typical features with discussion on the differential diagnosis that must be considered when such case is encountered.

Central giant cell granuloma (CGCG) is an uncommon, benign, idiopathic, osteolytic lesion of jaws, histologically characterized by multinucleated giant cells distributed in fibrovascular connective tissue stroma. Accurate diagnosis of the lesion is essential for the successful management and the prognosis of this locally destructive lesion. In this paper, a rare case of large destructive CGCG involving anterior region of mandible, causing expansion of labial cortical plate and mobility of teeth in a nine-year girl is presented. It was treated successfully by enucleation and curettage with satisfactory preservation of the continuity of mandible. Nine months post operatively, the child was rehabilitated with a temporary partial denture to improve esthetics, phonetics and function. One year clinical and radiographic follow up showed new bone formation and no evidence of recurrence.

Abstract Giant cell glioblastoma (GC-GBM) is a rare variant of IDH-wt GBM histologically characterized by the presence of numerous multinucleated giant cells and molecularly considered a hybrid between IDH-wt and IDH-mutant GBM. The lack of an objective definition, specifying the percentage of giant cells required for this diagnosis, may account for the absence of a definite molecular profile of this variant. This study aimed to clarify the molecular landscape of GC-GBM, exploring the mutations and copy number variations of 458 cancer-related genes, tumor mutational burden (TMB), and microsatellite instability (MSI) in 39 GBMs dichotomized into having 30–49% (15 cases) or ≥ 50% (24 cases) GCs. The type and prevalence of the genetic alterations in this series was not associated with the GCs content ( 10 mut/Mb, including two (5%) that harbored MSI and one with a POLE mutation. The frequency of RB1 and NF1 alterations and TMB counts were significantly higher compared to 567 IDH wild type (P

Aims: Pleomorphic xanthoastrocytoma (PXA) is a rare circumscribed glioma, characterized by frequent BRAF p. V600E mutation, and classified as grade 2 or 3. Owing to overlapping clinical–pathological features, the histological distinction from glioblastoma (GBM) with giant cells (GCs) is challenging. Based on the high frequency of TP53 and RB1 alterations in the latter, this study aimed to assess the value of BRAF, p53, and pRB immunostainings in the differential diagnosis. Methods and results: In 37 GBMs with ≥30% GCs and in eight PXAs, we assessed the alterations of 409 cancer-related genes and immunostainings for BRAF, p53, and pRB. GBMs with GCs were TP53- mutated in 30 cases, RB1-altered in 11, and BRAFmutated in none. PXAs were BRAF-mutated in six cases, TP53-mutated in three, and RB1-altered in none. pRb immunostaining was lost in 25 GBMs (11 RB1-altered and 14 RB1-unaltered), retained in all PXAs and six GBMs, and inconclusive in six GBMs. pRb loss had 100% specificity and 80.6% sensitivity for GBM with GCs. P53 immunostaining was observed in 22 TP53-mutated GBMs and in one TP53-mutated PXA. It showed 87.5% specificity and 60% sensitivity to identify GBM with GCs. BRAF immunostaining corresponded to BRAF mutation status and it had 100% specificity and 75% sensitivity for detecting PXA. Conclusion: This study shows for the first time that loss of pRB immunostaining is sensitive and specific for distinguishing GBM with GCs from PXA in routine practice. Thus, it could complement an immunohistochemical panel that includes BRAF and p53 immunostainings for the differential diagnosis. [ABSTRACT FROM AUTHOR]

It has been shown that severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2), by coronavirus disease 2019 (COVID‐19), can lead to multi‐organ impairment including cardiac involvement and immunological problems. Acute myocarditis is one of serious and fatal complications of COVID‐19. In this case report, we present a 46‐year‐old lady with a history of lichen planus dermatitis who has developed a rapidly progressive heart failure after an episode of COVID‐19. The pathologic examination of her endomyocardial biopsy specimens was compatible with GCM, and she was successfully treated with a combined immunosuppressive therapy regimen. [ABSTRACT FROM AUTHOR]

Purpose: The aim of this study was to characterize the cone-beam computed tomographic (CBCT) imaging features of central giant cell granuloma (CGCG) of the jawbone. Materials and Methods: This study retrospectively reviewed 26 CBCT studies of histologically proven cases of CGCG during a period of 20 years, from 1999 to 2019. Patients' demographic data were recorded, and radiographic features were assessed (location, border, cortication, appearance of the internal structure, locularity, septation, expansion, cortical perforation, effects on surrounding tissue, whether the lesion crossed the midline, and lesion volume). Results: In this study, CGCGs were seen almost twice as often in the mandible than in the maxilla, and 64.7% of mandibular lesions involved the anterior region. Only 26.9% of lesions crossed the midline, a feature that was considered characteristic of CGCG. Furthermore, 65.4% of lesions were unilocular and 34.6% were multilocular. The correlation between a lesion's size and its locularity was statistically significant, and larger lesions showed a multilocular appearance. The mean volume of multilocular lesions was greater than that of unilocular lesions. Conclusion: CGCGs showed variable radiographic features on CBCT, and this imaging modality is highly effective at demonstrating the radiographic spectrum and lesional extent of CGCGs in the jawbone. [ABSTRACT FROM AUTHOR]

Abstract It has been shown that severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2), by coronavirus disease 2019 (COVID‐19), can lead to multi‐organ impairment including cardiac involvement and immunological problems. Acute myocarditis is one of serious and fatal complications of COVID‐19. In this case report, we present a 46‐year‐old lady with a history of lichen planus dermatitis who has developed a rapidly progressive heart failure after an episode of COVID‐19. The pathologic examination of her endomyocardial biopsy specimens was compatible with GCM, and she was successfully treated with a combined immunosuppressive therapy regimen.

Lymphoepithelioma-like intrahepatic cholangiocarcinoma (LEL-ICC) is a rare liver tumor that appears as a hepatic nodule on imaging with a specific pathological pattern, and the definitive diagnosis relies on its pathological histomorphology, immunophenotype, and Epstein-Barr encoding region test. Radical surgical resection is the primary treatment modality, and immunotherapy is expected to be a new adjuvant treatment option. LEL-ICC with massive multinucleated giant cell infiltration has not been reported so far. In this article, we report a patient with LEL-ICC showing massive multinucleated giant cell infiltration, review the relevant literature, and analyze its clinicopathological features and prognosis to accumulate experience for the accurate diagnosis of LEL-ICC. [ABSTRACT FROM AUTHOR]

Adenocarcinoma of prostate with pleomorphic giant cells is very rarely encountered entity. It is necessary to identify this variant due to its highly aggressive clinical course and bad prognosis. Though this variant has been described in other sites, very few cases has been reported in the prostate till date. We report one such case with typical features with discussion on the differential diagnosis that must be considered when such case is encountered. [ABSTRACT FROM AUTHOR]

The Tzanck smear was introduced in the 1950s and has been used for the diagnosis of erosive, vesiculobullous, tumoral, and granulomatous diseases. The Tzanck smear is rapid, easy to perform, and relatively inexpensive. Results from this diagnostic test can be obtained at the bedside, often within several minutes. Tzanck smears have high diagnostic reliability for erosive/vesiculobullous and granulomatous lesions. For some lesions, the sensitivity of Tzanck smears can exceed 80% up to 90% depending on the expertise of the user. However, for more challenging diagnoses, Tzanck smear should be used in conjunction with more advanced techniques to ensure an accurate clinical diagnosis. This article reviews the background, indications, construct, and applications of the Tzanck smear to highlight this commonly used diagnostic tool in dermatology. [ABSTRACT FROM AUTHOR]

It is often documented that chronic irritation could be an etiology of oral cancer; yet out of negligence little heed is paid to any sort of discomfort until it grows to a sizable mass where it is difficult to go unnoticed. Intraorally, the source of irritation could vary from a jagged tooth edge to a chronic cheek bite. Furthermore, the removable prosthesis and orthodontic appliances can lead to alteration of the oral mucosal tissue. This case report represents one such sequelae of an ill-fitting dental prosthesis. Surprisingly and unfortunately, the broken denture was still in use by the patient until the damage caused by it could no further be ignored, it is then that the patient sought medical help. A histopathological diagnosis of reparative giant cell granuloma was made, and the patient was treated by successful excision of the same. [ABSTRACT FROM AUTHOR]

Giant cell glioblastoma (GC-GBM) is a rare variant of IDH-wt GBM histologically characterized by the presence of numerous multinucleated giant cells and molecularly considered a hybrid between IDH-wt and IDH-mutant GBM. The lack of an objective definition, specifying the percentage of giant cells required for this diagnosis, may account for the absence of a definite molecular profile of this variant. This study aimed to clarify the molecular landscape of GC-GBM, exploring the mutations and copy number variations of 458 cancer-related genes, tumor mutational burden (TMB), and microsatellite instability (MSI) in 39 GBMs dichotomized into having 30–49% (15 cases) or ≥ 50% (24 cases) GCs. The type and prevalence of the genetic alterations in this series was not associated with the GCs content (< 50% or ≥ 50%). Most cases (82% and 51.2%) had impairment in TP53/MDM2 and PTEN/PI3K pathways, but a high proportion also featured TERT promoter mutations (61.5%) and RB1 (25.6%) or NF1 (25.6%) alterations. EGFR amplification was detected in 18% cases in association with a shorter overall survival (P = 0.004). Sixteen (41%) cases had a TMB > 10 mut/Mb, including two (5%) that harbored MSI and one with a POLE mutation. The frequency of RB1 and NF1 alterations and TMB counts were significantly higher compared to 567 IDH wild type (P < 0.0001; P = 0.0003; P < 0.0001) and 26 IDH-mutant (P < 0.0001; P = 0.0227; P < 0.0001) GBMs in the TCGA PanCancer Atlas cohort. These findings demonstrate that the molecular landscape of GBMs with at least 30% giant cells is dominated by the impairment of TP53/MDM2 and PTEN/PI3K pathways, and additionally characterized by frequent RB1 alterations and hypermutation and by EGFR amplification in more aggressive cases. The high frequency of hypermutated cases suggests that GC-GBMs might be candidates for immune check-point inhibitors clinical trials. [ABSTRACT FROM AUTHOR]

Central giant cell granuloma (CGCG) is a benign non-neoplastic intraosseous lesion mainly found in the anterior mandible. It is characterized by multinucleated giant cells, representing osteoclasts or macrophages. Central odontogenic fibroma (COF) is an uncommon benign lesion of the jaws. It originates from the odontogenic ectomesenchyme. In rare cases, COF may accompany a CGCG. To date, 49 cases of COF accompanied by CGCG-like lesions have been reported in the literature. In this paper, we present another case of COF-CGCG in a 46-year-old female. The lesion was located in the posterior mandible. Excisional biopsy was carried out, and histopathological analysis revealed multinucleated giant cells with numerous strands of odontogenic epithelium. A literature review of previously reported cases was also performed.

Extrapulmonary tuberculous involvement of the musculoskeletal system is not common and seen in less than 10 % of all cases. The bidirectional association between tuberculous infection of the musculoskeletal system and rheumatological diseases has been widely recognized and arises both as a result their underlying immunosuppressive state and of drug induced immunosuppression. A 45-year-old female on treatment for SLE, in remission, presented with a slow growing mass over the dorsum of the right wrist with functional impairment which was clinically and radiologically compatible with a giant cell tumour. Pathological examination after surgical excision revealed pathognomonic features of tuberculous tenosynovitis. Multidrug antituberculous therapy was commenced. Clinical diagnosis of tuberculous tenosynovitis is difficult due to the non-specific clinical symptoms and signs. Laboratory investigations are usually normal except for ESR which may be elevated. Delay in establishing therapy may lead to dissemination of mycobacteria to the surrounding bursae, muscles and soft tissue leading to joint and tendon damage. Detection of mycobacteria through TB culture and microscopy of the specimen has a low sensitivity and therefore treatment should be promptly initiated when typical pathological findings are seen. Tuberculous tenosynovitis of the extensor tendons is a rare clinical presentation and must be suspected in cases of chronic and recurrent tendon sheath infection especially in an immunocompromised patient in a TB endemic country. The lack of clinical suspicion, nonspecific findings and mimicry of other conditions can lead to delayed diagnosis and complications. • The immunological derangements and use of immunosuppressive medication in diseases such as SLE, contribute to a higher prevalence of pulmonary and extrapulmonary TB. • Primary tuberculous tenosynovitis is rare accounting for 5% of osteoarticular TB. • Tuberculous tenosynovitis must be suspected in cases of chronic and recurrent tendon sheath infection. • Clinical diagnosis is difficult due to the non-specific clinical signs shared with other infective, inflammatory and neoplastic conditions affecting the synovium. • Definitive diagnosis of tuberculous tenosynovitis depends on histopathological examination and bacteriological confirmation [ABSTRACT FROM AUTHOR]

Peripheral giant-cell granulomas (PGCGs) are reddish color lesions of the gingiva which are frequently diagnosed on a routine basis by many dentists in the regular dental practice. Most of the lesions of PGCG are slow-growing, nonaggressive with asymptomatic, and tend to recur. Here, we exhibit a case of PGCG of the upper jaw in a 15-year-old girl child. She presented with a chief complaint of a lump on her upper anterior tooth region for 2-3 months. A well-defined painless, sessile exophytic growth, measuring about 1 cm × 0.5 cm in dimension with pinkish red in color with a firm consistency, was noted. Moreover, no secondary changes were seen. On the radiograph also, no changes in the bone/tooth were observed. The provisional diagnosis was identified as benign lesions such as pyogenic granuloma, peripheral ossifying fibroma, and PGCG and was made based on the clinical history and radiographic findings, and the confirmative diagnosis was given after histopathological examination. To improve the esthetic and function of teeth as well as psychological problems in the young patient, we tend to manage the case more simply by conservative surgical procedure at the earliest to prevent a recurrence. [ABSTRACT FROM AUTHOR]

Pleomorphic carcinoma (PC) is an uncommon and high-grade form of breast carcinoma characterized by the presence of distinctive pleomorphic giant tumor cells exhibiting bizarre nuclei and atypical mitosis. In this study, we report three patients who presented with lesions composed of a proliferation of large pleomorphic cells with a predominance of multinucleated giant cells on a microscope. Immunohistochemical analysis revealed distinct immunologic profiles within the respective malignant components. Notably, this report aims to contribute valuable insights, adding to the understanding of this uncommon tumor, accompanied by a literature review. Despite its rarity, PC in the breast remains clinically relevant due to its distinctive morphological and pathological features. These unique attributes require specific considerations in both clinical presentation and management., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2024, Anass et al.)